Arsenic Exposure and Type 2 Diabetes: A Systematic Review of the Experimental and Epidemiologic Evidence

Abstract

Chronic arsenic exposure has been suggested to contribute to diabetes development. We performed a systematic review of the experimental and epidemiologic evidence on the association of arsenic and type 2 diabetes. We identified 19 in vitro studies of arsenic and glucose metabolism. Five studies reported that arsenic interfered with transcription factors involved in insulin-related gene expression: upstream factor 1 in pancreatic β-cells and peroxisome proliferative-activated receptor γ in preadipocytes. Other in vitro studies assessed the effect of arsenic on glucose uptake, typically using very high concentrations of arsenite or arsenate. These studies provide limited insight on potential mechanisms. We identified 10 in vivo studies in animals. These studies showed inconsistent effects of arsenic on glucose metabolism. Finally, we identified 19 epidemiologic studies (6 in high-arsenic areas in Taiwan and Bangladesh, 9 in occupational populations, and 4 in other populations). In studies from Taiwan and Bangladesh, the pooled relative risk estimate for diabetes comparing extreme arsenic exposure categories was 2.52 (95% confidence interval, 1.69–3.75), although methodologic problems limit the interpretation of the association. The evidence from occupational studies and from general populations other than Taiwan or Bangladesh was inconsistent. In summary, the current available evidence is inadequate to establish a causal role of arsenic in diabetes. Because arsenic exposure is widespread and diabetes prevalence is reaching epidemic proportions, experimental studies using arsenic concentrations relevant to human exposure and prospective epidemiologic studies measuring arsenic biomarkers and appropriately assessing diabetes should be a research priority.

Examination of the effects of arsenic on glucose homeostasis in cell culture and animal studies: Development of a mouse model for arsenic-induced diabetes

“…Studies in this area of research have examined insulin secretion and glucose metabolism in cultured cells or laboratory animals exposed to highly toxic concentrations of As, which are incompatible with chronic exposures in humans. Therefore, data from these studies cannot be evaluated with respect to possible mechanisms of diabetes induced by environmental or occupational exposures and attempts to do so would inevitably yield confusing results (Navas-Acien et al, 2006). The following is a brief contextual review of laboratory studies that have examined the effects of As on processes directly related to glucose homeostasis.…”

Diabetes mellitus among arsenic exposed and non-exposed young adults in Bangladesh

“…[4][5][6]17,18 Studies conducted in different countries and also in Bangladesh revealed an association with arsenic exposure and diabetes. [4][5][6][7][8][9] According to the recent profile of Bangladesh International Diabetes Federation (BIDF), the prevalence of diabetes in the age group 30 to34 years was 4.5% and in the age group 35 to 39 years was 5.0%, while in the age group 60 to 64 years the prevalence (10.2%) was more than double. 19 The current study revealed a similar prevalence of diabetes among the age group 30 to 34 years (4.4%) and 35 to 39 years (5.0%).…”

“…3 Several studies have reported an association with arsenic exposure and diabetes mellitus. [3][4][5][6][7][8] Association of arsenic exposure with non-communicable diseases including Worldwide prevalence of diabetes mellitus is increasing in alarming way and is becoming a top cause of death. Every six seconds a person dies due to diabetes and it is projected that by 2030 diabetes will be the 7th leading cause of death.…”

Evaluation of the “Antidotal” Potential of Mangifera indica L. leaves extract on sodium arsenate exposed male Wistar rats using some biochemical markers

“…Also, pentavalent arsenate un-couples mitochondrial oxidative phosphorylation by a mechanism associated to competitive substitution of arsenate for inorganic phosphate in the formation of adenosine triphosphate (NRC, 2001). Some researchers also found out its increased risk of predisposing to diabetes mellitus, immunotoxicity and haematotoxicity respectively (ATSDR, 2005;Navas-Acien et al, 2006). In addition, it also causes genotoxicity with an unclear mechanism.…”